BACKGROUND: Melanocytes grown in pure monolayer culure lack many of the cellular interactions that exist in vivo. This can be partially overcome by growing melanocytes together with other epidermal cells in skin equivalent models. OBJECTIVE: The objective of the present study was to grow human melanocytes in human epidermis reconstructed on dermal substrates in vitro and to examine their response to UV radiation. METHODS: The skin equivalents were prepared by seeding cultured human keratinocytes together with cultured human melanocytes(in a ratio of 5%) onto de-epidermized dermis. After 7 days of culture, they were exposed to UVB irradiation(total 150m J/cm over 5days). On day 12 of air exposure the sections of the skin equivalents were prepared for histology. The structure of the skin equivalents was studied following staining with hematoxylin and eosin. Melanocytes were characterized by DOPA staining and by immunohistochemistry. RESULTS: Melanocytes were localized singly within the basal layer of the reconstructs. Melanin was also visible both in the melanocytes and in neighboring keratinocytes. There was an increase in melanocyte size and dendricity following UV irradiation. Melanocytes became positive to staining with HMB-45 antibody following UV irradiation. CONCLUSION: Our results indicate that melanocytes grown in reconstructed human epidermis are functional and capable of responding to UV irradiation.
Dermis ; Dihydroxyphenylalanine ; Eosine Yellowish-(YS) ; Epidermis* ; Hematoxylin ; Humans* ; Immunohistochemistry ; Keratinocytes ; Melanins ; Melanocytes* ; Skin

BACKGROUND: Paraquat is highly toxic herbicide used in agriculture, and mortality of paraquat poisoning is very high. The predictions of severity of poisoning assessed with the amount of ingestion, results of urine dithionite test and laboratory findings are not accurate. The aims of this study are to investigate whether Hart's probability of survival curves are useful for predicting outcomes of paraquat-poisoned patients and which factors influence the outcomes of the patients. METHODS: We grouped 175 patients with paraquat poisoning into seven groups using curves of probability of survival suggested by Hart, et al. Group A was patients with plasma paraquat concentration below 90% probability of survival curve, group B patients with paraquat levels between 90% and 70% probability of survival curves, group C patients with paraquat levels between 70 and 50% probability of survival curves, group D the ones with paraquat levels between 50% and 30% probability of survival curves, group E the ones with paraquat levels between 30 and 20% probability of survival curves, group F paraquat levels between 20 and 10% probability of survival curves, and group G patients with paraquat levels above 10% probability of survival curve. And we analyzed the survival and mortality rates of each groups. RESULTS: The mortality rates of groups A, B, C, D, E, F and G were 7.4%, 26.7%, 37.5%, 55.6%, 63.6 %, 83.3% and 96.8% respectively (p<0.0005). The most important risk factor for death of patients was the paraquat concentration grouping with odds ratios (95% CI) of 4.4 (0.7-27.5, group B), 7.2 (0.9-54.9, group C), 15.0 (52.1-105.6, group D), 21.0 (3.2-139.7, group E), 60.0 (7.4-487.1, group F), and 359.9 (56.9- 2277.9, group G). CONCIUSION: In assessing prognosis of patients with paraquat poisoning, grouping of the patients using initial plasma paraquat concentrations is the most important, and the policy of treatment can be decided according the results.
Agriculture ; Dithionite ; Eating ; Humans ; Logistic Models ; Mortality ; Odds Ratio ; Paraquat* ; Plasma ; Poisoning* ; Prognosis* ; Risk Factors

BACKGROUND: Paraquat is highly toxic herbicide used in agriculture, and mortality of paraquat poisoning is very high. The predictions of severity of poisoning assessed with the amount of ingestion, results of urine dithionite test and laboratory findings are not accurate. The aims of this study are to investigate whether Hart's probability of survival curves are useful for predicting outcomes of paraquat-poisoned patients and which factors influence the outcomes of the patients. METHODS: We grouped 175 patients with paraquat poisoning into seven groups using curves of probability of survival suggested by Hart, et al. Group A was patients with plasma paraquat concentration below 90% probability of survival curve, group B patients with paraquat levels between 90% and 70% probability of survival curves, group C patients with paraquat levels between 70 and 50% probability of survival curves, group D the ones with paraquat levels between 50% and 30% probability of survival curves, group E the ones with paraquat levels between 30 and 20% probability of survival curves, group F paraquat levels between 20 and 10% probability of survival curves, and group G patients with paraquat levels above 10% probability of survival curve. And we analyzed the survival and mortality rates of each groups. RESULTS: The mortality rates of groups A, B, C, D, E, F and G were 7.4%, 26.7%, 37.5%, 55.6%, 63.6 %, 83.3% and 96.8% respectively (p<0.0005). The most important risk factor for death of patients was the paraquat concentration grouping with odds ratios (95% CI) of 4.4 (0.7-27.5, group B), 7.2 (0.9-54.9, group C), 15.0 (52.1-105.6, group D), 21.0 (3.2-139.7, group E), 60.0 (7.4-487.1, group F), and 359.9 (56.9- 2277.9, group G). CONCIUSION: In assessing prognosis of patients with paraquat poisoning, grouping of the patients using initial plasma paraquat concentrations is the most important, and the policy of treatment can be decided according the results.
Agriculture ; Dithionite ; Eating ; Humans ; Logistic Models ; Mortality ; Odds Ratio ; Paraquat* ; Plasma ; Poisoning* ; Prognosis* ; Risk Factors

Colonoscopy is a safe and standard procedure for diagnosis and therapy of colonic disorders. Iatrogenic colonic perforation during diagnostic colonoscopy, a rare abdominal emergency, has an 0.3~0.8% incidence rate. The choice of treatment for this complication remains controversial. Prompt operative intervention is preferred to minimize morbidity and mortality. However, operative intervention is invasive and needs a long-term recovery period. Conservative treatment is less invasive but can lead to more extensive surgery in case of treatment failure. Very important point on the treatment of iatrogenic perforation of the colon during diagnostic colonoscopy is to avoid the leaking of intestinal contents into the intraperitoneal cavity. We report here a case in which an iatrogenic perforation of the colon during diagnostic colonoscopy was successfully treated by endoscopic clip therapy.
Colon* ; Colonoscopy* ; Diagnosis ; Emergencies ; Gastrointestinal Contents ; Incidence ; Mortality ; Treatment Failure

PURPOSE: The number of patients with HIV disease has been increasing rapidly, with anorectal discomfort being the most common complaint of these patients. However, there are no data on HIV disease relating to the benign anorectal area in Koreans. METHODS: A retrospective chart review was performed on patients diagnosed with benign anal diseases, combined with HIV disease, between 1996 and 2001. Their clinical aspects were compared with HIV patients registered with the National Institute of Health in Korea between 1985 and 2001. RESULTS: A total of 1,613 patients were registered, with the National Institute of Health in Korea, as having HIV disease. The ratio of sex was 7.2:1, with a male predominance. The disease was most common in the 3rd & 4th decades, with 64.2%, of the patients in this age range. As for the routes of transmission, sexual contact was the most common (96.9%), followed by blood transfusion (including blood products) (2.8%), vertical transmission (0.1%) and drug injection (0.1%). With regard to the sexual contact routes, homosexuality accounted for 28.0%. Of the cases of HIV disease presenting with a benign anal disease, 32 patients, with a sex ratio of 31:1, with an overwhelming male predominance, were selected. Twenty-six cases had been newly diagnosed at our hospital. As for the routes of the transmission, the disease had been transmitted by sexual contact in all cases. In 43.8% of these cases, the disease had been transmitted by homosexual contact, which showed a marked difference to that of the National database (P<0.05). For those associated with an anal diseases, there were 10 cases of anal fistula, 9 of perianal abscess, 7 of condyloma acuminata, 7 of anal fissure, 5 of hemorrhoids and 2 of ulceration on the lower rectum, noted. CONCLUSIONS: Nowadays, the numbers of anorectal-disease patients with HIV are increasing in Korea. Since HIV is common in the area of benign proctology, all proctologists must consider the possibility of HIV when managing patients.
Abscess ; Blood Transfusion ; Colorectal Surgery ; Fissure in Ano ; Hemorrhoids ; HIV Infections ; HIV* ; Homosexuality ; Humans ; Korea ; Male ; Rectal Fistula ; Rectum ; Retrospective Studies ; Sex Ratio ; Ulcer

We studied diabetic central neuropathy(DCN) that is not well-known neurologic disorder. for confirming its existence and then presenting objective diagnostic criteria and methods. Thirtysix diabetics(NIDDM: 30, IDDM: 6), men age 53.1 years, 21 males and 15 females, were com pared with 36 controls, mean age 51.5 years, 18 males and 18 females, electrophysiologically. First, we diagnosed peripheral polyneuropathy(PN) in diabetics by means of Diabetic Neuropathy Staging(DNS) developed at the University of Michigan and classified diabetics into two group; group I indicates diabetics with PN. group II diabetics without PN. Second, we studied central(cortico-cervical and cortico-lumbar) motor conduction time(CMCT) by means of magnetic motor-evoked potential (MEP) and central somatosensory conduction time by means of somatosensory-evoked potentials(SEP) stimulating on median and posterior tibial nerves. There were no significant differences(P>0.05) statistically in cortico-cervical CMCT between diabetics and controls. There were significantly more prolonged(P<0.01) in cortico-lumbar CMCT between diabetics and controls. In median nerve-evoked 3-channel SEP, N13-N20 (cortico-cervical) interpeak latency was significantly more prolonged(P<0.01) in diabetics than controls. In tibial nerve-evoked 2-channel SEP, P38-N22(cortico-lumbar) interpeak latency was significantly more prolonged(P<0.01) in diabetics than controls. In 30 patients(83.3%) of 36 diabetics, the study revealed central conduction delay in view of that above 2 or more abnormalities representing central conduction delay, that is, central neuropathy. In 10 patients(33.3%, M: 7, F:3) of diabetics with central neuropathy(30 patients), even though they had no PN, central conduction delay was revealed. Conclusively, in view of representing central conduction delay in 83.3% of patients, we believer that more active evaluations are needed in diabetics representing nonspecific central neurologic symptoms, for example, psychomotor slowing or cognitive dysfunctions, and MEP and SEP are useful in diagnosing DCN.
Diabetes Mellitus, Type 1 ; Diabetic Neuropathies ; Diagnosis* ; Female ; Humans ; Male ; Michigan ; Nervous System Diseases ; Neurologic Manifestations ; Tibial Nerve

Iterative decomposition of water and fat with echo asymmetry and the least-squares estimation (IDEAL) is a recently developed method for robust separation of fat and water with very high signal-to-noise-ratio (SNR) efficiency. In contrast to conventional fat-saturation methods, IDEAL is insensitive to magnetic field (B0 and B1) inhomogeneity. The aim of this study was to illustrate the practical application of the IDEAL technique in reducing metallic artifacts in postoperative patients with metallic hardware. The IDEAL technique can help musculoskeletal radiologists make an accurate diagnosis particularly in musculoskeletal imaging by reducing metallic artifacts, enabling the use of contrast enhancement, improving SNR performance, and providing various modes of MR images with one scan parameter.
Adipose Tissue ; Adult ; Aged ; *Artifacts ; Body Water ; Cartilage, Articular/pathology ; Contrast Media/diagnostic use ; Humans ; Least-Squares Analysis ; Magnetic Resonance Imaging/*methods ; Male ; Metals ; Middle Aged ; Phantoms, Imaging ; *Prostheses and Implants ; Signal-To-Noise Ratio

Neurilemmoma is wel1 encapsulated tumor of Schwann cell origin. It is more often solid than cystic and. usually solitary and may be benign. The treatment is surgical excision. We report a 42-year-old man hospitalized with complaints of RUQ pain and palpable mass. There was no endocrinological abnormality. Ultrasonography, computerized tomography and angiography revealed right huge extrarenal mass without metastatic evidence. The patient underwent surgical excision.
Adult ; Angiography ; Humans ; Neurilemmoma* ; Ultrasonography

Despite recent advances in the care of such patients, subarachnoid haemorrhage(SAH) due to ruptured intracerebral aneurysm continues to carry a high rate of morbidity and mortality. During the acute phase of SAH, various factors can aggravate a patients initial good neurological state, and every effort should thus be made to prevent such occurrences. Although not a major problem, seizure is a well known factor influencing the course of the disease. The authors studied 476 cases of SAH occurring during the preceding eight-year period and reported the incidence of seizure, the risk factors which evoke it, and the optimal time required to prevent it. The incidence was 11%, and 48% of seizures occurred within three days of SAH. The risk factors were Hunt-Hess grade at admission, degree of neurologic deficit, and the presence and timing of rebleeding. Regardless of initial grade, seizure led to a poorer outcome. We conclude that seizure in aneurysmal subarachnoid hemorrhage occurs during the early stage of the disease and aggravates the prognosis. The recognition of risk factors and early prevention of seizure are thus necessary.
Aneurysm ; Humans ; Incidence ; Intracranial Aneurysm* ; Mortality ; Neurologic Manifestations ; Prognosis ; Risk Factors ; Seizures* ; Subarachnoid Hemorrhage

PURPOSE: In about 1% of cases, incidental gallbladder cancers (iGBC) are found after routine cholecystectomy. The aim of this study is to compare clinical features of iGBC with benign GB disease and to evaluate factors affecting recurrence and survival. METHODS: Between January 1998 and March 2014, 4,629 patients received cholecystectomy and 73 iGBC patients (1.6%) were identified. We compared clinical features of 4,556 benign GB disease patients with 73 iGBC patients, and evaluated operative outcomes and prognostic factors in 56 eligible patients. RESULTS: The iGBC patients were older and concomitant diseases such as hypertension and anemia were more common than benign ones. And an age of more than 65 years was the only risk factor of iGBC. Adverse prognostic factors affecting patients' survival were age over 65, advanced histology, lymph node metastasis, and lymphovascular invasion on multivariate analysis. Age over 65 years, lymph node involvement, and lymphovascular invasion were identified as unfavorable factors affecting survival in subgroup analysis of extended cholecystectomy with bile duct resection (EC with BDR, n = 22). CONCLUSION: Prior to routine cholecystectomy, incidental GB cancer should be suspected especially in elderly patients. And advanced age, lymph node metastasis, and lymphovascular invasion are important prognostic factors in EC with BDR cohorts.
Aged ; Anemia ; Bile Ducts ; Cholecystectomy* ; Cohort Studies ; Gallbladder Neoplasms* ; Gallbladder* ; Humans ; Hypertension ; Lymph Nodes ; Multivariate Analysis ; Neoplasm Metastasis ; Prognosis ; Recurrence ; Risk Factors